Osteitis pubis: This condition is characterized by inflammation of the pubic bone and its surrounding structures, often due to overuse or trauma, which could be common in elderly individuals due to decreased bone density and increased likelihood of falls.

Pubic ramus fracture: Given the age of the patient, osteoporosis could be a contributing factor, making fractures more likely even with minimal trauma.
Osteoarthritis of the pubic symphysis: Wear and tear on the joint between the two pubic bones can cause pain in this area, especially in older adults.
Urinary tract infection or prostatitis (in men): While these conditions primarily affect the urinary system, they can radiate pain to the pubic area.

Appendicitis (if the appendix is located in a retrocecal position): Although less common, appendicitis can present with pain in the lower abdomen that might be perceived as pubic pain, especially if the appendix is not in its typical location.
Ectopic pregnancy (in women of childbearing age, though unlikely at 74): Extremely rare but potentially life-threatening if missed.
Testicular torsion (in men): Another emergency condition that could potentially cause radiating pain to the pubic area.
Ovarian torsion (in women): Similar to testicular torsion, this is a gynecological emergency.

Metastatic bone disease: Cancer that has spread to the pubic bone could cause pain in this area, though it would be less common without a known history of cancer.
Paget's disease of bone: A condition that affects bone remodeling, leading to bone pain, including in the pubic area, though it's relatively rare.
Pubic bone osteomyelitis: An infection of the pubic bone, which is uncommon but could occur, especially in the context of trauma or compromised immune status.